Search

Purpose: The incidence of salivary duct carcinoma (SDC) seems to be underestimated due to inaccurate classification. Further, the frequency of SDC patients with targeted therapy options according to current guidelines is unclear. Therefore, this study aimed at (a) describing the proportion of SDC among salivary gland carcinoma (SGC) before and after reclassification of cases initially classified as adenocarcinoma, not otherwise specified (ANOS); and (b) quantifying the frequency of SDC patients with targeted therapy options., Methods: All patients with SDC or ANOS treated in a tertiary care center between 1996 and 2023 were identified. Histopathological diagnosis was verified for patients primarily diagnosed with SDC and reviewed for patients initially diagnosed with ANOS. Clinical data for SDC patients were retrieved from clinical charts. Immunohistochemical (IHC) androgen receptor (AR) and HER2 staining was performed., Results: Among 46 SDC, 34 were primarily diagnosed as SDC and 12 had initially been classified as ANOS. The proportion of SDC among SGC was 12.1% and was rising when comparing the time periods 2000-2015 (7.1-11.5%) versus 2016-2023 (15.4-18.1%). Nuclear AR staining in > 70% of tumor cells was found in 56.8% and HER2 positivity (IHC 3 +) in 36.4% of cases. 70.5% of patients showed AR staining in > 70% of tumor cells and/or HER2 positivity and therefore at least one molecular target. 5-year overall and disease-free survival (DFS) were 62.8% and 41.0%. Multivariate Cox regression revealed positive resection margins (HR = 4.0, p = 0.03) as independent negative predictor for DFS., Conclusions: The results suggest a rising SDC incidence and show that the extent of the AR and HER2 expression allows for targeted therapy in most SDC cases., (© 2024. The Author(s).)

The 8th edition of the AJCC/UICC TNM-staging system for p16[HPV]-positive OPSCC manages to improve prediction of prognosis and will essentially influence choice of therapy in future. Nonetheless, adjustments of the current version are needed. The surrogate marker p16 alone is inadequate for HPV detection, the role of ECS in HPV-positive OPSCC is not fully understood, and the patient's characteristics as well as molecular signatures and genetics have not been taken into consideration yet.

Sialendoscopy is an established, minimally invasive technique to diagnose and treat obstructive disorders of major salivary glands. Knowledge about patient satisfaction and quality of life is limited. All patients who underwent sialendoscopy were prospectively followed and evaluated. To determine the quality of life after sialendoscopy, an established questionnaire was evaluated (Short-Form-36 Health Survey-SF-36). To determine patient satisfaction, a self-made questionnaire was applied and evaluated. Furthermore, postoperative follow-up examination and the amount of patients who could be saved from sialadenectomy were determined. Main reasons for sialendoscopy were recurrent or permanent swelling of the affected salivary gland. 46 patients were included, 52 sialendoscopies were performed. Immediately after sialendoscopy operative ablation of the respective gland was averted in 98.1 % of the patients. After the follow-up period of 225.4 ± 79.0 days operative ablation of the respective gland was avoided in 89.9 % of the patients. Overall, 85.2 % reported an improvement of symptoms during follow-up, however, values for role-physical functioning (p = 0.025) and bodily pain (p = 0.011) still showed a significant difference when compared to a matched reference group of healthy individuals. Significant negative influence factors towards the outcome were younger age, long-term duration of symptoms and selected SF-36 items (vitality, social functioning, and mental health). Operative ablation of major salivary glands can be avoided by means of sialendoscopy in high percentages during short-term. There seems to be a high patient satisfaction in these selected cases. The duration of preoperative symptoms appears to be an important factor predisposing towards poor satisfaction.

The extracardiac juvenile rhabdomyoma is extremely rare in the field of Otorhinolaryngology. The tumour usually arises from the soft tissue of the face or from mucosal sites, especially the oropharynx and the oral cavity but only sporadic endolaryngeal cases have been described in literature so far with predominance of young males. Here, we describe the very rare case of endolaryngeal extracardiac juvenile rhabdomyoma in a 42-year-old male. Clinical examination showed a mass of the right vocal cord, resembling a cystic lesion. Microlaryngoscopy revealed a non-encapsulated lesion and histopathology including immunohistochemistry which consecutively led to the correct diagnosis. This case suggests that the endolaryngeal extracardiac juvenile rhabdomyoma can be easily confused with a vocal cord cyst. Malignant transformations have not been reported but recurrences have been described. When total excision cannot be accomplished, reoperation or narrow follow-up is indicated to prevent advanced revision surgeries.